February Update

On June 1st, 2014, the state of Indiana plans to transition its Medicaid program from “209(b)” to “1634” status. As a result, major changes are planned for the Medicaid for the Aged, Blind, & Disabled program. Our goal remains to provide you and your patients / clients / consumers with the ClaimAid Advantage.

Spend Down to be eliminated

Indiana will no longer be required to operate its spend down program under “1634” status.

What you need to know: Approximately 76,000 people in Indiana are currently enrolled in Medicaid using the spend down program. Depending on the income level and the specific program of eligibility, these individuals may remain eligible for their current category of Medicaid or may be transitioned to another Medicaid program. Some will no longer qualify for Medicaid and will be referred to the Health Insurance Marketplace or advised to purchase a Medicare Supplement Plan.

Disability determinations will be made by the Social Security Administration

Indiana will begin to require application to the Social Security Administration (SSA) for Disability benefits as part of the Medicaid for the Disabled application.

What you need to know: Applications for Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) are complex and typically take longer than the state Medicaid Disability process. The Indiana Office of Medicaid Policy & Planning (OMPP) has stated that they will not eliminate the state Medical Review Team (MRT) process, though the SSA determination will be ultimately be used for program eligibility. If you have specific questions about how this may impact your operations, please CONTACT US.

Hospital Presumptive Eligibility

Effective January 1, 2014, qualified hospitals may participate in the new “Hospital Presumptive Eligibility” HPE program.

What you need to know: The table below details the aid categories and income limits for the new program. If your organization would like more information on this program, please CONTACT US. You may access the Hospital Presumptive Eligibility Qualified Provider Manual in its entirety by clicking HERE.

New Employer Mandate Delays

On February 10th, U.S. Treasury Officials released new rules that further delay the “employer mandate” requiring businesses to provide health insurance or pay a penalty.

What you need to know: Employers with 50 to 99 employees will not be required to cover full-time staff until 2016. Employers with 100 or more workers will be required to provide health insurance to 70 percent of full-time staff next year and then 95 percent beginning in 2016.

For more details and up-to-date information, please contact J Hopkins, Vice President at 800.842.4052 x126 or by email at jhopkins@claimaid.com.

About Us

ClaimAid is a leading provider of full-service eligibility and claims resolution for hospitals, patients and their families. As the health marketplace continues to evolve and new coverage options emerge, ClaimAid will continue to guide our clients through the process, helping them understand the options available and what the changes mean for them.